Concise representation for review of a subjective refraction test

ABSTRACT

A concise representation illustrating essential elements of a subjective refraction eye test that includes choices of optics offered to a test subject, responses by the test subject indicating respective choices among the optics, and time durations of, between, or both of and between, responses by the test subject indicating the respective choices of optics. The concise representation includes a presentation that illustrates the essential elements of the eye test.

PRIORITY AND RELATED APPLICATIONS

This application claims the benefit of priority to United Statesprovisional patent applications No. 62/655,193, filed Apr. 9, 2018;62/793,366, filed Jan. 16, 2019; and 62/806,911, filed Feb. 18, 2019;each of which are hereby incorporated by reference.

The present application is related to U.S. Pat. Nos. 9,743,829,9,730,578, 9,408,533, 9,320,426, 9,247,871, 8,967,801, 8,950,865,8,684,527, 8,632,184, 8,632,183, 8,409,177, 8,388,137, 8,366,274,8,262,220, 8,113,658, 8,033,664, 7,959,284, 7,954,950, 7,909,461,7,824,033, 7,748,844, 7,726,811, 7,699,471, 7,695,134, 7,490,940,7,461,938, 7,425,067, 7,293,871, 7,114,808, 6,706,036, 6,210,401,5,280,491, 5,549,632, and 5,984,916, and to published United Statespatent applications nos.: 2018/0092525, 2018/0070811, 2008/0039825,2008/0208363, 2008/0212024, 2016/0310001, 2006/0217688.

Each of the above patents and published patent applications isincorporated by reference.

BACKGROUND

Traditionally, an ophthalmologist, physician, or an optometrist, or atechnician, sits with a patient during an eye exam for the entirety ofthe test. The time taken by the physician, optometrist or physician'sassistant or other authorized trained person is the duration of theentire test. The physician, optometrist or trained technician is highlyskilled and highly compensated. Their time is valuable and therefore,the testing time is very expensive. It is desired to reduce the amountof time spent by the physician, optometrist or technician and/or toeliminate, replace or substitute with less expensive personnel for atleast some of the testing time would be beneficial.

One way to achieve this would be to record the whole process on an audioand/or video recording. However, recording takes the same amount oftime. Moreover, whoever reviews the audio and/or video recording wouldtake the same amount of time as sitting through the entire test. It isdesired to have a way of presenting the essential elements of a test toa physician, optometrist and/or other skilled person or technician thattakes significantly less time than a duration of a subjective refractiontest.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1A includes an example of a table indicating numerically certainessential elements, including optical power and test subject responsetime and step size for an example subjective refraction eye test forascertaining aberrations of sphere for a right eye of a test subject inaccordance with certain embodiments.

FIG. 1B includes an example of a table indicating certain numericallyessential elements, including optical power and test subject responsetime and step size for an example subjective refraction test forascertaining cylinder aberrations for a right eye of a test subject inaccordance with certain embodiments.

FIG. 1C illustrates a concise representation of a subjective refractioneye test that includes an example of a table indicating certainnumerically essential elements of a more or less typical subjectiverefraction test for a test subject's right eye for ascertainingastigmatism or axis angle aberrations, wherein essential elements mayinclude optical powers of choices of optics offered to the test subject,time durations taken by the test subject for responding, and the opticscommunicated by the test subject as a selection in each case from amonga plurality of choices, in accordance with certain embodiments.

FIG. 2A includes an example of concise representation of a refractioneye test that includes a table indicating numerically essential elementsof an example subjective refraction test for a test subject's right eyefor ascertaining aberrations of sphere, including optical powers ofchoices by the test subject from among multiple optics offered to thetest subject, time durations of, or intervals between, responses by thetest subject, and the choices communicated by the test subject, alongwith a bar chart illustrating the time durations of responses of thetest subject overlaying a line plot of the optical powers of the choicesof optics offered to the test subject, in accordance with certainembodiments.

FIG. 2B includes an example of a table indicating numerically essentialelements of an example subjective refraction test for a test subject'sright eye for ascertaining cylinder aberrations, including opticalpowers of each choice of optics offered to the test subject, the timedurations of each response of the test subject and the choices of opticscommunicated by the test subject, along with a bar chart illustratingthe time durations of each response of the test subject overlaying aplot of the optical powers of the choices of optics offered to the testsubject.

FIG. 2C includes an example of a table indicating numerically essentialelements of an example subjective refraction test for a test subject'sright eye for ascertaining astigmatism or axis angle aberrations,including optical powers of each choice of optics offered to the testsubject, the time durations of each response of the test subject and thechoices of optics communicated by the test subject, along with a barchart illustrating the time durations of each response of the testsubject overlaying a plot of the optical powers of the choices of opticsoffered to the test subject.

FIG. 3 includes an example of a table as stand-alone conciserepresentation or as one component of a concise representation of asubjective refraction eye test indicating numerically essential elementsof another example subjective refraction eye test for ascertainingsphere, cylinder and astigmatism or axis angle aberrations for right andleft eyes of a test subject in accordance with certain embodiments.

FIG. 4 includes an example of a table as a stand-alone conciserepresentation or as one component of a concise representationindicating numerically essential elements of another example subjectiverefraction test for a test subject's right and left eyes forascertaining sphere, cylinder and astigmatism or axis angle aberrationsin accordance with certain embodiments.

FIG. 5 includes an example of a stand-alone concise representation orone component of a multi-component concise representation of asubjective refraction eye test including a plot of changes in opticalpower versus response times for a portion of an example subjectiverefraction test in accordance with certain embodiments, with the trendappearing to be linear and with positive slope.

FIG. 6 includes an example of another stand-alone concise representationor one component of a multiple component concise representation thatincludes a plot of optical power versus total response time for aportion of an example subjective refraction test in accordance withcertain embodiments.

FIG. 7 includes another example of a stand-alone concise representationor a component of a multiple component concise representation thatincludes a plot of optical power versus response time for a portion ofan example subjective refraction test in accordance with certainembodiments.

FIG. 8 includes another example of a plot using the date in Test 1 ofthe right eye, that show the sphere power versus the cumulative time ofthe test in accordance with certain embodiments.

DETAILED DESCRIPTION OF THE EMBODIMENTS

Several embodiments including example methods of preparing a conciserepresentation of a subjective refraction eye test for review by anoptometrist or physician are provided. For the purpose of referring tothe authorized refractionists, such as ophthalmologist, optometrist,physician's assistant, or other authorized refraction technicians, theymay be referred to as refraction experts throughout the specification orin the claims. Essential elements of a subjective refraction eye testare captured. Essential elements include choices of optics offered tothe patient, responses of the patient indicating a choice among saidoptics, and time durations taken by the patient for each response. Aconcise representation of the test is generated. The conciserepresentation includes a presentation that illustrates the essentialelements of the refraction test.

Some example embodiments are particularly suited to apply totelemedicine, where one highly trained; skilled physician may be at aremote location, and the physician may be overseeing multiple locationswhere patients are to be refracted or treated. The utility andefficiency of the physician is greatly enhanced. The costs to each testsubject of having the benefit of a highly skilled, highly educated andhighly compensated physician overseeing their subjective refraction eyetest in real time can be significantly reduced when the physiciancontemporaneously oversees one or more additional eye tests occurring atspaced apart locations. Alternatively, the physician may attend only asubset of the entire test, e.g., at the end of the subjective refractioneye test, or after the test is finished, either right afterwards beforethe test subject leaves the testing area or significantly later at ascheduled conference call date and time, when in each case a conciserepresentation of data gathered during the eye test is generated andprovided to the physician who can digest the test results quicker whenprovided in an efficient illustrative format that highlights theessential elements and their impact on the test subject's quality ofvision so that diagnostic or prognostic options may be gleaned in afraction of the time it typically takes to run the entire eye test. Suchconcise representation is generated from the raw data gathered in theeye test and processed in accordance with scientifically proved formulassuch that the concise representation is reliable as being based inscience.

A concise representation may be configured in accordance with certainembodiments to provide a compact, e.g., a single 8.5×11 single ordouble-sided summary of the data gathered during the subjectiverefraction eye test, or perhaps two or three pages, including one to sixgraphs, plots, charts, or other presentations of comparative orstandardized eye test data that allows a physician or optometrist orskilled eye care technician a condensed, brief and information reportthat includes all of the essential elements needed for the physician toopine as to treatments or other next steps. Since all essential elementsof a test are presented in a concise representation to the physician, itprovides the physician the benefits of experiencing what exactlyhappened, without being physically present at the location.

The presentation may include one or more charts, plots, and/or graphsthat each illustrate one or more of the essential elements. Thepresentation may include one or more charts, plots and/or graphs foreach of the left and right eyes of the patient. The presentation mayinclude one or more charts, plots and/or graphs for compensating therefractive errors in the sphere, cylinder and axis for each of the leftand right eyes of the patient.

The presentation may include one or more tables indicating numericallyan optical power of each of the choices of optics offered to thepatient, the patient's response indicating a choice among said optics,and the time durations of each response of the patient. The presentationmay include one or more tables indicating numerically an optical powerof each of the choices of optics offered to the patient and the timedurations of each response of the patient for each of left and righteyes of the patient. The presentation may include one or more tablesindicating numerically an optical power of each of the choices of opticsoffered to the patient and the time durations of each response of thepatient for compensating the refractive errors in the sphere, cylinder,and axis for each of the left and right eyes of the patient.

The presentation may include a bar chart illustrating the time durationsof each response by the patient. The presentation may also include aplot of optical powers of each of the choices of optics offered to thepatient, and the patient's response indicating a choice among saidoptics. Slopes of the plot may illustrate step sizes of changes inoptical power between successive choices of optics offered to thepatient.

The presentation may include a bar chart illustrating the time durationsof each response of the patient overlaying the plot of optical powers.The data points may be equally spaced along the x-axis, oralternatively, the data points may be spaced along the x-axis inaccordance with the response times.

The essential elements may include step sizes of changes in opticalpower between successive choices of optics offered to the patient, andthe patient's response indicating a choice among said optics.

The method may also include communicating the concise representation toan optometrist or physician, the refraction expert.

The method may also include performing a subjection refraction eye test.

The presentation may include a continuous audio recording or assembly ofaudio clips of patient responses to said choices of optics overlaying agraphical presentation illustrating said choices of optics or saidpatient response times or both.

The presentation may include a continuous video recording or assembly ofvideo clips or a slide show of still images showing patient responses tothe choices of optics.

The presentation may include a continuous video recording or assembly ofvideo clips or a slide show of still images showing patient responses tothe choices of optics overlaying a graphical presentation illustratingthe choices of optics or the patient response times or both.

The method may also include compressing the presentation for remotestorage, transmission to an optometrist or physician, display or editingor combinations thereof.

One or more non-transitory processor-readable digital storage devicesare also provided in accordance with certain embodiments. The one ormore devices have code embedded therein for programming a processor toperform a method of preparing a concise representation of a subjectiverefraction eye test for review by an optometrist or physician accordingto any of the example embodiments describe above or below herein.

A processor-based device is also provided herein that includes aprocessor, one or more non-transitory processor-readable digital storagedevices having code embedded therein for programming said processor toperform a method of preparing a concise representation of a subjectiverefraction eye test for review by an optometrist or physician accordingto any of the example embodiments describe above or below herein, andelectronics configured for one or more of transmitting, displaying,storing, translating or editing the concise representation of thesubjective refraction eye test for review by the optometrist orphysician.

The essential elements may include step sizes of changes in opticalpower between successive choices of optics offered to the patient.Reviewer may see a trend or a correlation of optics step size versus theduration in the response in the test, thereby building a betterrefraction test to the patient in general.

The concise digital representation may include a continuous audiorecording or assembly of audio clips of patient responses to the choicesof optics overlaying a graphical presentation illustrating the choicesof optics or the patient response times or both. The concise digitalrepresentation may include a continuous video recording or assembly ofvideo clips or a slide show of still images showing patient responses tothe choices of optics.

The concise digital representation may include a continuous videorecording or assembly of video clips or a slide show of still imagesshowing patient responses to the choices of optics overlaying agraphical presentation illustrating the choices of optics or the patientresponse times or both.

FIGS. 1A-1C illustrate an example of a concise presentation of arefraction eye test. In FIG. 1A, a patient was undergoing an eye test,in this case attempting to cancel the refractive errors in the sphereaberrations of the right eye. In the first column of FIG. 1A, test 1 islabeled for this data group in the testing of the sphere. In the secondcolumn, the duration in units of seconds were recorded. In this example,the patient was presented with 0.93D sphere, at first. The last column,seq. for the test sequence numbering. In sequence 1, the patientresponded after a duration of 6 seconds (column2) to indicate more minusvalue in sphere was preferred. In the fourth column, labeled Step size,is to mark the incremental step change in the sphere value, in this caseit was set at 0.5D. In the next test sequence, 0.5D more minus power waspresented to the patient, now at 0.43D. Patient again requested moreminus sphere power. It took patient 5 seconds this time to make thatcall. After a 0.5D more minus move, the optics power is at −0.07D, etc.

One of essential elements of refraction is to gauge whether the patientis giving reliable answer, or it was just a random guess. The durationor the time for the patient to make a decision is a good measure of howconfident is the patient's answer. If the duration is at 6 seconds ofless for the patient to decide a choice, the patient has good confidenceto provide an answer. It's answer would lead to a good final end point.Conversely, it a patient is uncertain about the answer, it may takelonger period of time to decide. If the duration is over 12 seconds, itis indication that the answer can only be trust with lower level ofconfidence.

Hence, with a glance at the bar chart in FIG. 1A, the refractionistreviewer can tell how the test went, and should the reliability of thetest be in question.

FIG. 1B illustrates the part of refraction test on the optical axis.Here, 111 degrees axis was presented to the patient. The answer frompatient was “perfect for me”. A “0” mark in the step size columnindicates that particular test was completed. The time duration was 7seconds for the patient to decide.

Moving on to FIG. 1C. This a test on the cylinder power on the right eyeof the patient. −0.34D was presented. It took 15 seconds to decide.Patient requested more plus cylinder power. 0.25D cylinder was providedto the patient. The cylinder setting is now at 0.16D. The patient stillrequested even more plus power. The next optics presented to the patientwas 0.66D as shown in the third column of the table. The patient took 8seconds to decide that that value is perfect for it, and the text iscompleted for the cylinder power.

For the patient's left eye, data were illustrated in FIG. 2. FIG. 2A isto test the sphere aberrations of the patient's left eye. FIG. 2B is totest the axis angle of the astigmatism. FIG. 2C is to test the cylinderpower of the patient left eye. FIGS. 2A through 2C are functionallyidentical to the FIGS. 1A through 1C respectively.

The representation of the eye test can be formatted in a variation ofways. In FIG. 3, the patient data are presented in a table form insteadof bar charts and graphs. In the first column, the test #1 through 6 areidentical in function as in FIGS. 1 and 2. Test 1 is to test the sphereaberrations of the patient's right eye, Test 2 is to test the axis, Test3 is to test the cylinder power of the eye's aberrations. Test 4 is totest the sphere aberrations of the patient's left eye. Test 5 is to testthe axis of the left eye. Test 6 is to test the cylinder power of thepatient's left eye. The test sequence is in column 2. When the testchanges from sphere to axis, the test sequence breaks and returns tostarting from number 1. The reviewer understands that is indication of achange of test, in this case from testing sphere to testing axis. Allother data point are formatted in consistency as in FIGS. 1 and 2. Inthe representation, one can pick out when and where in the tests thatpatient may experience long response time, indicating difficulties forthe patient. One may use color code to highlight the cells under thetime column (column 3, here) so it become obviously clear where in theentire refraction eye test. As example, one can color a time range ofresponse time below 4 seconds in green. Color code the cells between >4to 7 seconds in yellow. Over 7 seconds to 11 seconds in orange, and over12 seconds in red. Such color representation tells the reviewer in oneglance how confident is the patient in answering the choices in the eyetest. Lots of green and yellow cells are good tests. Red and orangecells indicate patient confusion. The reliability of the test may becalled to question.

In FIG. 4, another example of a refraction eye test from anotherpatient. All columns and data formats follow those in FIG. 3.

In FIG. 8, a plot of the optics power versus the time at a certain testsequence. In this plot, the time at a sequence number is the cumulativetime, not the duration time for answering one presentation of choices.In this example, data points of Test 1 in FIG. 1A is plotted. In thisrepresentation one can see the entire test 1 of FIG. 1A, starting fromthe first presentation of 0.93D in sphere, in sequence 1, to 0.43D insequence 2, etc., to the last data point of 0.43D in sequence 12. Onecan see the length of the lines joining each of the test sequence,representing the time duration specific to that test sequence.Furthermore, the overall time from sequence 1 to the last one sequence12, took over 80 seconds. However, a reviewer who is used to looking atsuch plots will grash the whole sphere refraction of Test 1 in a coupleof seconds by looking at the plot. Therefore, the reviewer has thebenefits of “seeing” the entire test 1 in 1/40 of the total time, as ifthe reviewer was at the side of the patient during the test.

Returning to the example of FIGS. 1A-2C, 3 and 4, FIG. 1A includes anexample of a table indicating numerically essential elements of anexample subjective refraction eye test for ascertaining aberrations ofsphere for a right eye of a test subject. The essential elementsindicated numerically on the left hand side in FIG. 1A as a table thatincludes columns including information regarding essential elements ofthe subjective refraction eye test.

In the left-most column, an indication of a test number for a testsubject are provided in the six (6) drawings FIGS. 1A, 1B, 1C, 2A,2Band-2C, or FIGS. 1A-2C, which are sequentially tests 1 thru 6 for thisparticular test subject. The next column to the right includes timedurations taken by the test subject for communicating responses, or timeintervals between responses, or alternatively, changes in time intervalsbetween responses by the test subject before new optics are offered tothe test subject based typically on the most recent previous response orthe most recent 2, 3 or 4 previous responses.

The time duration taken by the test subject to communicate a response orthe change of time duration or rate of change may each suggest, more orless to a refraction expert, that the test subject has indicated largeror smaller noticeable distinctions in viewing quality between sets ofoptics, and may suggest a proximity to optimum, and/or a direction ofoptimum toward which to adjust optical power and offer a new optic atthe adjusted optical power, among other indications or suggestions thata trained refraction expert, such as an ophthalmologist, optometrist,optician, or geometric linear or nonlinear optics scientist, engineer ortrained technician.

Each distinct optic is presented to the test subject for comparison withone or more current or previously sampled optics. The choices indicatedby the test subject among the optics and patterns of choices may suggestdiagnostic or prognostic techniques or analysis or next steps to arefraction expert or to a technician assisting in the test subject'sperformance of a subjective refraction eye test, or to the test subjectherself or himself who may be using a partially or completely automatedrefraction instrument to generate results presentable in a conciserepresentation on a mobile phone, tablet, reader, laptop or desktopcomputer or display or other graphic rendering device.

The optical power of the optics chosen by the test subject each step ofthe way toward an optimum optical prescription are indicated in the3^(rd) column from the left in FIG. 1A. The step sizes are provided inthe next column to the right in FIG. 1A. Step sizes are increments orchanges in optical power between successively sampled optics. Largerstep sizes are typically used at first until a certain proximity tooptimum is suggested to the refraction expert or technician or to anautomated-test subject following programmed instructions or systematicguidance tools or process facilitation algorithms with voice or keypador trackball, or joystick, or mouse, or gesture recognition deviceproximately or remotely operated or guided by the test subject,technician or refraction expert or completely self-contained as anautomatic system trained with the latest AI technology or other learningalgorithms or feedback mechanism or sign-on profile driven systems thatstore past tests, past and/or current prescriptions and other ophthalmicinformation for the test subject who is recognized by the system fromany of several possibly greatly spaced apart terminals, kiosks or mobilepersonal digital devices running appropriate application programs.Whereupon the closer the human expert senses or the automatic systemcalculates that a subjective refraction eye test is to the optimumcorrective optic for the test subject, the smaller the step sizes willbecome and the greater the likelihood of incrementing back toward anoptical power previously tested only this time adjusting the opticalpower in smaller increments until an optimum setting is determined tohave been found for a particular optical aberrational parameter has beenfound, such as sphere (FIGS. 1A and 2A), cylinder (FIGS. 1B and 2B), orastigmatism power or axis angle (FIGS. 1C and 2C), or until acombination of such aberrational parameters has been found such as inthe eye test concisely represented numerically at FIG. 3 or FIG. 4 whichare example tables including sphere, cylinder and astigmatism test datatogether in combination tables.

FIG. 1A also includes a bar chart illustrating time durations taken by atest subject for communicating responses, or time intervals betweenresponses that indicate or suggest a choice among multiple opticsoffered to the test subject. The bar chart of FIG. 1A utilizes the leftvertical axis which is adjusted to include each of the 12 data pointsfrom lowest to highest appearing in the “time” column of the table2^(nd) from the left most column in FIG. 1A for the response timeparameter. The line plot of FIG. 1A utilizes the right vertical axis,which is adjusted to include each of the 12 data points from lowest tohighest appearing in the optical power column which is 3^(rd) from theleft most column in FIG. 1A. Both the bar chart and line plot in FIG. 1Autilize the bottom horizontal axis to evenly space the twelve steps inthe subjective refraction eye test illustrated in the conciserepresentation at FIG. 1A of a test for spherical aberrational errorthat can be corrected by compensating for the sphere error, if any, ofthe right eye of this test subject using corrective contacts, glasses oran intraocular lens or using corrective laser surgery or another more orless invasive or noninvasive surgical technique based on an accuratedetermination of a sphere aberrational error for the test subject.

The bar chart presented in FIG. 1A is shown overlaying the plot ofoptical powers of selected optics indicated by the test subject duringthe subjective refraction eye test. The optical power starts high as theline plot shows and is reduced to a minimum at the sixth sphereadjustment step and is increased back up nearly to the starting highvalue at the end but at a somewhat slower rate of increase for the lasthalf of the data points acquired and plotted in FIG. 1A compared withthe rate of decrease for the first half of the data points acquired andplotted in FIG. 1A. The bar chart appears to trend from shorter responsetimes at steps 1, 2, 3 when the optical power is highest within the datapoints used to illustrate this technique, to the longest response timesat steps 4, 5, 6, 7, 8, and 9 plotted in the bar chart from the table ofFIG. 1A, when the optical power is lowest, and back to shorter responsetimes at higher optical powers at the end of the subjective refractionsphere aberrational error eye test at steps 10, 11, 12. The lineardecrease and then substantially linear increase in optical power shownin the line plot corresponds to an oppositely trending linear increasein response time for steps 1-6 and then a similar linear response timedecrease from steps 7-12.

FIG. 1B includes an example of a table indicating numerically essentialelements of an example subjective refraction test for ascertainingcylinder aberrations for a right eye of a test subject. The essentialelements indicated numerically in FIG. 1B include optical powers ofchoices by the test subject among multiple optics offered to the testsubject, time durations taken by the test subject for communicatingresponses or time intervals between responses, and the choices indicatedby the test subject in each case over a distinct option. FIG. 1B alsoincludes a bar chart illustrating time durations taken by the testsubject for communicating responses or time intervals between responses.The bar chart is presented in FIG. 1B overlaying a plot of opticalpowers of optics selected by the test subject from among multiple opticsoffered to the test subject.

FIG. 1C includes an example of a table indicating numerically essentialelements of an example subjective refraction test for a test subject'sright eye for ascertaining astigmatism or axis angle aberrations,including optical powers of each choice of optics offered to the testsubject, time durations taken by the test subject for responding, andthe optics communicated by the test subject as a selection in each casefrom among a plurality of choices. FIG. 1C also includes a bar chartillustrating time durations, or time intervals between responses,indicated by the test subject showing a linearly decreasing responsetime trend. The bar chart is shown overlaying a line plot of opticalpowers for the choices of corrective optics offered to the test subjectduring the subjective refractive eye test in the example of FIG. 1Cillustrating that there is a tendency of the response times to decreaselinearly with linearly increasing corrective optical astigmatism power.

FIGS. 2A-2C correspond to test for sphere, cylinder and astigmatism,respectively, for the left eye of the test subject whose right eye wastested producing the FIGS. 1A-1C described above. In FIG. 2A, increasingsphere correctional optical power appears to be associated withdecreasing response times for test subjects. The cylinder test for theleft eye of the test subject appears to show a linearly proportionatetrend between decreasing from step 1 to step 2 the response time of thetest subject or increasing from step 2 to step 3 the response time ofthe test subject, and decreasing from step 1 to step 2 the optical poweror increasing from step 2 to step 3 the optical power. These trendssuggest a certain significant, reliable corrective prescription to arefraction expert who only needs to study the data in the conciserepresentation, assuming the data has been properly acquired, toformulate and communicate a diagnosis and/or prognosis for this testsubject's left eye cylinder errors. FIG. 2C appears to indicateproportional increases in response times with increases in opticalpower, and decreases in response times with decreases in optical powerfor the left eye astigmatism of the test subject.

FIG. 2A includes an example of a table indicating numerically essentialelements of an example subjective refraction test for a test subject'sright eye for ascertaining aberrations of sphere, including opticalpowers of choices by the test subject from among multiple optics offeredto the test subject, time durations of, or intervals between, responsesby the test subject, and the choices communicated by the test subject.FIG. 2A also includes a bar chart illustrating the time durations ofeach response of the test subject overlaying a plot of the opticalpowers of the choices of optics offered to the test subject.

FIG. 2B includes an example of a table indicating numerically essentialelements of an example subjective refraction test for a test subject'sright eye for ascertaining cylinder aberrations, including opticalpowers of each choice of optics offered to the test subject, the timedurations of each response of the test subject and the choices of opticscommunicated by the test subject. FIG. 2B also includes a bar chartillustrating the time durations of each response of the test subjectoverlaying a plot of the optical powers of the choices of optics offeredto the test subject.

FIG. 2C includes an example of a table indicating numerically essentialelements of an example subjective refraction test for a test subject'sright eye for ascertaining astigmatism or axis angle aberrations,including optical powers of each choice of optics offered to the testsubject, the time durations of each response of the test subject and thechoices of optics communicated by the test subject. FIG. 2C alsoincludes a bar chart illustrating the time durations of each response ofthe test subject overlaying a plot of the optical powers of the choicesof optics offered to the test subject.

FIG. 3 includes an example of a table indicating numerically essentialelements of another example subjective refraction eye test forascertaining sphere, cylinder and astigmatism or axis angle aberrationsfor right and left eyes of a test subject. The table of FIG. 3 listsoptical powers of choices among pluralities of optics offered to thetest subject, the time durations taken by the test subject forcommunicating responses or time intervals between responses, and choicesof optics indicated by the test subject over distinct options. Thecolumn of choices made by the test subject includes nullities which areindications that neither the higher nor lower power optics offered areas good as the present optic, which suggests reducing the increment ofchange in optical power and presenting new higher and lower power opticsless spaced apart in optical power than the previous ones and stillcentered at the current optical power, whereas positive or negativeunities suggest increasing or decreasing the optical power from which topresent new optics options of respectively still higher or still loweroptical power at large increments until the appropriate optical power isnear enough to reduce the increments and even present both higher andlower optical power options around a potential optimal center value.Many examples beyond these are possible depending on the experience andpreferences of those involved in setting up the subjective refractioneye test guidelines, those performing the test or assisting a testsubject to substantially perform the test without assistance, and/orthose refraction experts, which may include physicians, optometrists,and/or highly skilled, moderately skilled, or modestly skilledtechnicians, who will be called upon to review results and provide adiagnostic or prognostic analysis, protocol or prescription.

FIG. 4 includes an example of a table indicating numerically essentialelements of another example subjective refraction test for a testsubject's right and left eyes for ascertaining sphere, cylinder andastigmatism or axis angle aberrations. The table of FIG. 4 lists opticalpowers of choices selected among, for each choice, a plurality of opticsoffered to the test subject, time durations taken by the test subjectfor communicating responses or time intervals between responses, whilealternatively total elapsed time from a common starting time may bedisplayed or presented, or transmitted or stored, in a table that may besimilar to, but in this way distinct from, the example table illustratedat FIG. 4.

The table of FIG. 4 also includes a column including only nullitiesalong with a few positive and negative unities. The null entries mayrepresent an indication by the test subject of no preference oralternatively favoring the status quo, while an indication of positiveunity suggests a next optic with increased optical power and anindication of negative unity suggests a next optic of lower opticalpower, or alternatively, positive unity may suggest continuing to changeoptical power in a same direction, while negative unity may suggestreversing a direction of change of optical power back towards a previousoptic that is now favorably indicated over a current choice, whileanother option may permit positive and negative dualities and/or theirmultiplicative inverses, i.e., plus half and minus half as indicationsby the test subject to adjust optical power more or less drasticallythan the last change of optical power.

FIG. 5 includes a plot of changes in optical power versus response timesfor a portion of an example subjective refraction test in accordancewith certain embodiments. The trend appears to be linear and withpositive slope.

FIG. 6 includes a plot of optical power versus total response time for aportion of an example subjective refraction test in accordance withcertain embodiments. The trend appears to be “V” shaped, includinglinearly decreasing optic power with total time for the first 35 secondsof the subjective refraction eye test illustrated in FIGS. 4 and 6, andthen a linear increasing to logarithmic or reverse parabolic trend withpositive slope is shown in FIG. 6 after 35 seconds out to 100 seconds orso.

FIG. 7 includes a plot of optical power versus response time for aportion of an example subjective refraction test in accordance withcertain embodiments. A trend is shown whereby the optic power appears todecrease linearly with increasing response time, similar to the trendshown in FIGS. 1A and 1C and described in some detail above.

FIG. 8 includes a plot using the date in Test 1 of the right eye, thatshow the sphere power versus the cumulative time of the test. TheHorizontal axis is for Cumulative Time. Vertical axis is Sphere Power.

While an exemplary drawing and specific embodiments of the presentinvention have been described and illustrated, it is to be understoodthat that the scope of the present invention is not to be limited to theparticular embodiments discussed. Thus, the embodiments shall beregarded as illustrative rather than restrictive, and it should beunderstood that variations may be made in those embodiments by workersskilled in the arts without departing from the scope of the presentinvention, as set forth in the claims below and structural andfunctional equivalents thereof.

In addition, in methods that may be performed according to preferredembodiments herein and that may have been described above, theoperations have been described in selected typographical sequences.However, the sequences have been selected and so ordered fortypographical convenience and are not intended to imply any particularorder for performing the operations, unless expressly set forth orunderstood by those skilled in the art being necessary.

I claim:
 1. A method of preparing a digital representation of a subjective refraction eye test for review by an optometrist or physician, comprising: capturing elements of a subjective refraction eye test, including: choices of optical lenses offered to the patient; responses of the patient; and time durations of each response of the patient; and generating a digital representation of said test including a presentation that illustrates said elements, wherein said presentation comprises one or more tables indicating numerically an optical power of each of said choices of optical lenses offered to said patient and said time durations of each response of the patient.
 2. The method of claim 1, wherein said presentation further comprises one or more charts, plots, or graphs, or combinations thereof, that each illustrate one or more of said elements.
 3. The method of claim 2, wherein said presentation further comprises one or more charts, plots or graphs, or combinations thereof, for each of left and right eyes of the patient.
 4. The method of claim 3, wherein said presentation further comprises one or more charts, plots or graphs, or combinations thereof, wherein the choices of optical lenses provide choices for compensating errors of sphere, cylinder and axis for said each of said left and right eyes of said patient.
 5. The method of claim 1, wherein said presentation further comprises a bar chart illustrating the time durations of each response by the patient.
 6. The method of claim 5, wherein the choices of optical lenses provides choices of varying optical powers, and wherein said presentation further comprises a plot of optical powers of each of said choices of optical lenses offered to said patient.
 7. The method of claim 1, wherein said presentation comprises one or more tables indicating numerically an optical power of each of said choices of optical lenses offered to said patient and said time durations of each response of the patient for each of left and right eyes of the patient.
 8. The method of claim 7, wherein said presentation comprises one or more tables indicating numerically an optical power of each of said choices of optical lenses offered to said patient and said time durations of each response of the patient, wherein the choices of optical lenses provide choices for compensating errors of sphere, cylinder, and axis for each of said left and right eyes of said patient.
 9. The method of claim 1, wherein said presentation further comprises one or more charts, plots, or graphs, or combinations thereof, that illustrate each of the elements.
 10. The method of claim 9, wherein said presentation further comprises a plot of optical powers of each of said choices of optical lenses offered to the patient.
 11. The method of claim 10, wherein slopes of said plot illustrate step sizes of changes in optical power between successive choices of optical lenses offered to the patient.
 12. The method of claim 10, wherein said presentation further comprises a bar chart illustrating the time durations of each response of the patient overlaying said plot of optical powers.
 13. The method of claim 12, wherein data points are equally spaced along the x-axis.
 14. The method of claim 10, wherein data points are spaced along the x-axis in accordance with the response times.
 15. The method of claim 1, wherein said elements further comprise step sizes of changes in optical power between successive choices of optical lenses offered to the patient.
 16. The method of claim 1, further comprising communicating said digital representation to an optometrist or physician.
 17. A method of preparing a digital representation of a subjective refraction eye test for review by an optometrist or physician, comprising: capturing elements of a subjective refraction eye test, including: choices of optical lenses offered to the patient; responses of the patient; and time durations of each response of the patient; and generating a digital representation of said test including a presentation that illustrates said elements, wherein said presentation comprises a continuous audio recording or assembly of audio clips of patient responses to said choices of optical lenses overlaying a graphical presentation illustrating said choices of optical lenses or said patient response times or both.
 18. The method of claim 17, wherein said presentation further comprises a continuous video recording or assembly of video clips or a slide show of still images showing patient responses to said choices of optical lenses optics.
 19. A method of preparing a digital representation of a subjective refraction eye test for review by an optometrist or physician, comprising: capturing elements of a subjective refraction eye test, including: choices of optical lenses offered to the patient; responses of the patient; and time durations of each response of the patient; and generating a digital representation of said test including a presentation that illustrates said elements, wherein said presentation comprises a continuous video recording or assembly of video clips or a slide show of still images showing patient responses to said choices of optical lenses overlaying a graphical presentation illustrating said choices of optical lenses or said patient response times or both.
 20. The method of claim 19, further comprising compressing said presentation for remote storage, transmission to an optometrist or physician, display or editing or combinations thereof.
 21. One or more non-transitory processor-readable digital storage devices having code embedded therein for programming a processor to perform a method of preparing a digital representation of a subjective refraction eye test for review by an optometrist or physician according to claim
 1. 22. A processor-based device, comprising: a processor; one or more non-transitory processor-readable digital storage devices having code embedded therein for programming said processor to perform a method of preparing a digital representation of a subjective refraction eye test for review by an optometrist or physician according to claim 1; and electronics configured for one or more of transmitting, displaying, storing, translating or editing said representation of said subjective refraction eye test for said review by said optometrist or physician.
 23. A digital representation of a subjective refraction eye test for communicating to an optometrist or physician for review, comprising a presentation that illustrates elements of said test including choices of optical lenses offered to the patient, responses of the patient, and time durations of said responses of the patient, wherein said presentation comprises one or more tables indicating numerically an optical power of each of said choices of optical lenses offered to said patient and said time durations of each response of the patient.
 24. The digital representation of claim 23, wherein said presentation further comprises one or more charts, plots, or graphs, or combinations thereof, that each illustrate one or more of said elements.
 25. The digital representation of claim 24, wherein said presentation further comprises one or more charts, plots or graphs, or combinations thereof, for each of left and right eyes of the patient.
 26. The digital representation of claim 25, wherein said presentation further comprises one or more charts, plots or graphs, or combinations thereof, wherein the choices of optical lenses provide choices for compensating errors of sphere, cylinder and axis for said each of said left and right eyes of said patient.
 27. The digital representation of claim 23, wherein said presentation further comprises a bar chart illustrating the time durations of each response by the patient.
 28. The digital representation of claim 27, wherein said presentation further comprises a plot of optical powers of each of said choices of optical lenses offered to said patient.
 29. The digital representation of claim 23, wherein said presentation comprises one or more tables indicating numerically an optical power of each of said choices of optical lenses offered to said patient and said time durations of each response of the patient for each of left and right eyes of the patient.
 30. The digital representation of claim 29, wherein said presentation comprises one or more tables indicating numerically an optical power of each of said choices of optical lenses offered to said patient and said time durations of each response of the patient for compensating errors of sphere, cylinder, and axis for each of said left and right eyes of said patient.
 31. The digital representation of claim 23, wherein said presentation further comprises one or more charts, plots, or graphs, or combinations thereof, that illustrate each of the elements.
 32. The digital representation of claim 31, wherein said presentation further comprises a plot of optical powers of each of said choices of optical lenses offered to the patient.
 33. The digital representation of claim 32, wherein slopes of said plot illustrate step sizes of changes in optical power between successive choices of optical lenses offered to the patient.
 34. The digital representation of claim 32, wherein said presentation further comprises a bar chart illustrating the time durations of each response of the patient overlaying said plot of optical powers.
 35. The digital representation of claim 34, wherein said plot includes data points that are equally spaced along the x-axis.
 36. The digital representation of claim 32, wherein said plot includes data points that are spaced along the x-axis in accordance with the response times.
 37. The digital representation of claim 23, wherein said elements further comprise step sizes of changes in optical power between successive choices of optical lenses offered to the patient.
 38. A digital representation of a subjective refraction eye test for communicating to an optometrist or physician for review, comprising a presentation that illustrates elements of said test including choices of optics offered to the patient, responses of the patient, and time durations of said responses of the patient, wherein said presentation comprises a continuous audio recording or assembly of audio clips of patient responses to said choices of optical lenses overlaying a graphical presentation illustrating said choices of optical lenses or said patient response times or both.
 39. The digital representation of claim 38, wherein said presentation further comprises a continuous video recording or assembly of video clips or a slide show of still images showing patient responses to said choices of optical lenses.
 40. A digital representation of a subjective refraction eye test for communicating to an optometrist or physician for review, comprising a presentation that illustrates elements of said test including choices of optical lenses offered to the patient, responses of the patient, and time durations of said responses of the patient, wherein said presentation comprises a continuous video recording or assembly of video clips or a slide show of still images showing patient responses to said choices of optical lenses overlaying a graphical presentation illustrating said choices of optical lenses or said patient response times or both. 